Evolution of Anxiety and Depression in Men during the First Six Months of the COVID-19 Pandemic and Factors Associated with Worsening of Mental Health: Retrospective Longitudinal Study

Background: The Coronavirus disease (COVID-19) pandemic has had a huge impact on the psychological wellbeing of the population, however, few studies have analysed the psychological consequences for the most vulnerable groups, particularly those suffering from depression and anxiety, and specifically in men. The objective of this study is to analyse the changes in a population of men undergoing active treatment for depression or anxiety and factors associated with these changes. Methods: Retrospective, longitudinal and observational study of a population of 28,294 men in northern Spain. The study variables were sociodemographic variables, chronic comorbidities, COVID-19 infection, anxiolytic and antidepressant drug consumption, and use of healthcare resources. These variables were collected from the Primary Health Care electronic records for the two distinct periods (6 months before and 6 months following the end of the lockdown). To compare drug patterns and the use of healthcare resources a paired Student’s T-test was used. To analyse associated factors related to a deterioration of mental disorders, a multivariate logistic regression was performed. Results: In relation to changes in drug patterns, 40% of men saw an increase in at least one Defined Daily Dose (DDD) of their prescribed drugs during the 6 months following lockdown and the number of appointments at health centres and home visits significantly decreased. Factors associated with a deterioration of mental disorders are being under 60 years old, having an income of less than 18,000 euros/year and suffering from more than one comorbidity. Conclusions: The pandemic had a significant impact on men with a previous diagnosis of depression and/or anxiety

Perfil clínico de los pacientes diagnosticados de Diabetes Mellitus tipo 2 en el área sanitaria de Vigo

Type 2 Diabetes Mellitus is a chronic disease that represent an important problem of public health. The objective of this study was to describe the sociodemographic, anthropometric, metabolic control, comorbidity and cardiovascular risk characteristics of patients diagnosed with Diabetes Mellitus type 2 in the health area of Vigo. Retrospective observational descriptive study. Between March and September 2016, it did telephone interview and an audit of electronic medical records to 195 patients ≥ 18 years old from the health area of Vigo diagnosed with type 2 Diabetes Mellitus. It selected by random sampling with replacement. It evaluated the cardiovascular risk using the method "United Kingdom Prospective Diabetes Study", the metabolic control with the recommendations of the "American Diabetes Association" 2016, and the comorbidity using the Charlson index. It performed a descriptive and bivariate analysis with R statistical package. The glycemic control was adequate (HbA1c less than 7.0%) in the 61.03% of the patients. The 58.46% had a blood pressure under 140/90mmHg, 52.82% had a total cholesterol under 185mg/dl and 66.15% had a triglyceride level under 150mg/dl. The 49.74% presented a high comorbidity (Charlson larger or the same as 3 points). The risk of suffering and/or dying of heart disease was 37.81%, and 23.50% of suffering and/or dying of a stroke in the next 10 years. Most diabetic patients of the health area of Vigo have a good control of their disease but they present a high index of comorbidity and high cardiovascular risk.Fundamentos. La Diabetes Mellitus tipo 2 es una enfermedad crónica que representa un importante problema de salud pública. El objetivo de este estudio fue describir las características sociodemográficas, las antropomé - tricas, el control metabólico, la comorbilidad y el riesgo cardiovascular de los pacientes diagnosticados de Diabetes Mellitus tipo 2 del área sanitaria de Vigo. Método. Estudio descriptivo observacional retrospectivo. Entre marzo y setiembre de 2016, se realizó entrevista telefónica y auditoria de historia clínica electrónica a 195 pacientes ≥ 18 años del área sanitaria de Vigo diag - nosticados de Diabetes Mellitus tipo 2. Se seleccionaron mediante muestreo aleatorio con reposición. Se evaluó el riesgo cardiovascular mediante el mé - todo “United Kingdom Prospective Diabetes Study”, el control metabólico según las recomendaciones de la “American Diabetes Association” 2016, y la comorbilidad mediante el índice de Charlson. Se realizó un análisis descriptivo y bivariante con el paquete estadístico R. Resultados. El control glucémico era adecuado (HbA1c<7,0%) en el 61,03% de los pacientes. El 58,46% tenía una tensión arterial <140/90mmHg, 52,82% un colesterol total <185mg/dl y un 66,15% un ni - vel triglicéridos <150 mg/dl. El 49,74% presentaron una comorbilidad alta (Charlson ≥3 puntos). El riesgo de padecer y/o fallecer de una enfermedad cardíaca era del 37,81%, y del 23,50% el de padecer y/o fallecer de un acci - dente cerebrovascular en los próximos 10 años. Conclusiones. La mayoría de los pacientes diabéticos del área sanitaria de Vigo tienen un buen control de su enfermedad pero presentan un alto índice de comorbilidad y un elevado riesgo cardiovascular. Palabras clave . Diabetes Mellitus Tipo 2, Comorbilidad, Factores de Riesgo, Hemoglobina A Glucosilada

Interrupted time series analysis of pediatric infectious diseases and the consumption of antibiotics in an Atlantic European region during the SARS-CoV-2 pandemic

The increasing concern about bacterial resistance has made the rational prescription of antibiotics even more urgent. The non-pharmacological measures established to reduce the impact of the SARS-CoV-2 pandemic have modified the epidemiology of pediatric infections and, consequently, the use of antibiotics. Interrupted time series (ITS) analyses are quasi-experimental studies that allow for the estimation of causal effects with observational data in “natural experiments”, such as changes in health policies or pandemics. The effect of the SARS-CoV-2 pandemic on the incidence of infectious diseases and the use of antibiotics between 2018 and 2020 in the Health Area of Vigo (Galicia, Spain) was quantified and analyzed. This paper outlines a real-world data study with administrative records from primary care services provided for the pediatric population. The records were related to episodes classified as infectious by the International Classification of Primary Care (ICPC-2) and oral medication in the therapeutic subgroup J01, corresponding to antibiotics for systemic use, according to the World Health Organization’s Anatomical Therapeutic Chemical (ATC) classification system. The records were classified according to incident episodes, age, dose per inhabitant, and year. Segmented regression models were applied using an algorithm that automatically identifies the number and position of the change points. During the SARS-CoV-2 pandemic, the number of infectious diseases being transmitted between individuals, through the air and through the fecal–oral route, significantly decreased, and a slight decrease in infections transmitted via other mechanisms (urinary tract infections) was also found. In parallel, during the months of the pandemic, there has been a marked and significant reduction in antibacterial agent utilization, mainly of penicillins, cephalosporins, and macrolides.ISCIII Network for Research on Chronicity, Primary Care, and Health Promotion | Ref. RD21/0016/002

Utilidad diagnóstica del cuestionario STOP-Bang en la apnea del sueño moderada en atención primaria

Objetivo: Validar el cuestionario STOP-Bang para la apnea moderada frente al método de referencia (polisomnografía de tipo I) en atención primaria. Método: Estudio de utilidad diagnóstica en atención primaria con una muestra estimada de 85 casos y 85 controles sanos. Con muestreo por conveniencia, 203 pacientes fueron reclutados por sus médicos en seis centros de salud. Se excluyeron 25 y se analizaron 57 mujeres y 121 hombres, de los cuales 74 tenían un índice de hipopnea-apnea (IHA) ≥15. Se evaluaron el STOP-Bang y el IHA observado en la polisomnografía en cada paciente. El tamano˜ de la muestra, el análisis de la curva ROC y los puntos de corte óptimos se identificaron con los paquetes easyROC, pROC y OptimalCutpoints del software libre R. Resultados: El área bajo la curva en la apnea moderada (IHA ≥15) del STOP-Bang fue 0,737 (0,667-0,808), con puntos de corte óptimos diferentes por sexo (4 en mujeres y 6 en hombres). En la validación cruzada con k = 10, el área bajo la curva para el STOP-Bang fue 0,678. Conclusiones: El STOP-Bang tiene una utilidad diagnóstica moderada para un IHA ≥15, pero superior a la de otras escalas, en una población comunitaria. Su desempeno˜ es más adecuado en las mujeres